OBJECTIVETo investigate the triaging pathways of patients after coronary computed tomography angiography (CCTA).

METHODSThe patients undergoing CCTA were enrolled consecutively during the period from March 3, 2008 to June 23, 2009. The rate of coronary angiography (CAG) examinations after CCTA was calculated. The rates of normal CAG, medication, percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) were compared between CCTA and direct CAG cohorts.

RESULTSA total of 8030 cases receiving CCTA and 3260 receiving direct CAG were included in the study. The CCTA patients had significantly fewer risk factors than those having direct CAG. Of the 8030 patients undergoing CCTA, 953 (12.03%) received further CAG and 6977 (87.97%) did not. Of the patients who received CAG after CCTA, 35 (3.7%) had normal CAG findings, 604 (63.4%) underwent PCI, 108 (11.3%) received conservative treatment with medications, and 206 (21.6%) underwent CABG. In the 3260 patients directly undergoing CAG, 706 (52.3%) underwent subsequent PCI, 142(4.4%) underwent CABG, 815(25.1%) received medications, and 579 (17.9%) had normal CAG findings. Comparison between the cases receiving direct CAG and CAG after CCTA showed that CCTA resulted in a significant increase in the revascularization rate (P<0.0001).

CONCLUSIONCCTA can help prevent unnecessary CAG and allows more accurate patient triage.

Coronary Angiography ; methods ; Coronary Artery Disease ; diagnostic imaging ; therapy ; Female ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed

Objective To investigate the triaging pathways of patients after coronary computed tomography angiography (CCTA). Methods The patients undergoing CCTA were enrolled consecutively during the period from March 3, 2008 to June 23, 2009. The rate of coronary angiography (CAG) examinations after CCTA was calculated. The rates of normal CAG, medication, percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) were compared between CCTA and direct CAG cohorts. Results A total of 8030 cases receiving CCTA and 3260 receiving direct CAG were included in the study. The CCTA patients had significantly fewer risk factors than those having direct CAG. Of the 8030 patients undergoing CCTA, 953 (12.03%) received further CAG and 6977 (87.97%) did not. Of the patients who received CAG after CCTA, 35 (3.7%) had normal CAG findings, 604 (63.4%) underwent PCI, 108 (11.3%) received conservative treatment with medications, and 206 (21.6%) underwent CABG. In the 3260 patients directly undergoing CAG, 706 (52.3%) underwent subsequent PCI, 142(4.4%) underwent CABG, 815(25.1%) received medications, and 579 (17.9%) had normal CAG findings. Comparison between the cases receiving direct CAG and CAG after CCTA showed that CCTA resulted in a significant increase in the revascularization rate (P<0.0001). Conclusion CCTA can help prevent unnecessary CAG and allows more accurate patient triage.

Objective To investigate the triaging pathways of patients after coronary computed tomography angiography (CCTA). Methods The patients undergoing CCTA were enrolled consecutively during the period from March 3, 2008 to June 23, 2009. The rate of coronary angiography (CAG) examinations after CCTA was calculated. The rates of normal CAG, medication, percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) were compared between CCTA and direct CAG cohorts. Results A total of 8030 cases receiving CCTA and 3260 receiving direct CAG were included in the study. The CCTA patients had significantly fewer risk factors than those having direct CAG. Of the 8030 patients undergoing CCTA, 953 (12.03%) received further CAG and 6977 (87.97%) did not. Of the patients who received CAG after CCTA, 35 (3.7%) had normal CAG findings, 604 (63.4%) underwent PCI, 108 (11.3%) received conservative treatment with medications, and 206 (21.6%) underwent CABG. In the 3260 patients directly undergoing CAG, 706 (52.3%) underwent subsequent PCI, 142(4.4%) underwent CABG, 815(25.1%) received medications, and 579 (17.9%) had normal CAG findings. Comparison between the cases receiving direct CAG and CAG after CCTA showed that CCTA resulted in a significant increase in the revascularization rate (P<0.0001). Conclusion CCTA can help prevent unnecessary CAG and allows more accurate patient triage.

Objective:To explore the effect of behavioral habits on the recovery of spinal cord function in patients with cervical spondylotic myelopathy after expansive open-door laminoplasty(ELAP).Methods:Retrospective analysis of clinical data of 183 patients with cervical spondylotic myelopathy who underwent ELAP at the Spinal Surgery Department of Jining Medical University Affiliated Hospital, from February 2019 to October 2022, with complete follow-up information. General clinical data of patients were collected. The patients were followed up at 3 months, 6 months and 12 months after surgery with the modified standard MacNab.The JOA score was used to evaluate the recovery of motor and sensory functions in patients before and 12 months after surgery. The recovery rate of spinal cord function was calculated based on the JOA score, and patients were divided into two groups: the group with good therapeutic effect ( n=143, recovery rate ≥ 50%) and the group with poor therapeutic effect ( n=40, recovery rate<50%). Data statistics were conducted using SPSS 20.0 software for chi-square test, rank sum test, t-test, and Logistic regression analysis. Results:There were significant differences in age ( t=-3.252, P<0.01), smoking ( χ2=21.503, P<0.01), body mass index(BMI) ( t=-5.885, P<0.01), hypertension ( χ2=20.263, P<0.01), coronary heart disease ( χ2=13.272, P<0.01), hospitalization time ( t=-2.278, P=0.02), desk and screen time ( t=-6.589, P<0.01), and frequency of rehabilitation exercise ( χ2=10.927, P<0.01) between the group with good therapeutic effect and the group with poor therapeutic effect. Further multivariate Logistic regression analysis showed that smoking ( B=2.402, OR=11.046, 95% CI=2.334-52.285, P<0.05), high BMI ( B=0.341, OR=1.406, 95% CI=1.076-1.837, P<0.05), hypertension ( B=2.238, OR=9.370, 95% CI=2.153-40.790, P<0.05), long desk and screen time ( B=0.961, OR=2.613, 95% CI=1.540-4.435, P<0.05) and low frequency of rehabilitation exercise ( B=-1.039, OR=0.354, 95% CI=0.201-0.623, P<0.05) were risk factors for spinal cord function recovery in patients with cervical spondylotic myelopathy after ELAP( P<0.05). Conclusion:Smoking, high BMI, hypertension, long desk and screen time, and low frequency of rehabilitation exercise are not adverse to the recovery of neurological function in patients with cervical spondylotic myelopathy after ELAP.